2011-2012 Dependent Verification Worksheet



2020-2021 Verification Worksheet V5

[pic]Dependent Student [pic]Independent Student

List below the people in your parent’s household. Please Include:

• Yourself and your parent(s) (including stepparent) even if you don’t live with your parents.

• Your parents’ other children, if your parents will provide more than half of their support from July 1, 2020 through June 30, 2021, or the children would be required to provide parental information if they were completing a FAFSA for 2020-2021. Include children who meet either of these standards, even if they do not live with your parent(s).

• Other people if they now live with your parents and your parents provide more than half of their support and will continue to provide more than half of their support through June 30, 2021.

.

Include the name of the college for any household member EXCLUDING YOUR PARENT(s), who will be attending at least half time between July 1, 2020 and June 30, 2021, enrolled in a degree or certificate program. Attach separate sheet for more space.

|Full Name |Age |Relationship |College or University |Will be Enrolled at|

| | | |(Please do not list schools from |least Half Time |

| | | |Pre-School-High School) | |

| | |SELF | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

______Yes, I have used the IRS Data Retrieval tool to retrieve and transfer my 2018 IRS income information on the FAFSA.

_______I, have not used the IRS Data Retrieval Tool, but will use the tool to transfer my 2018 IRS income information to the

FAFSA once I have filed.

_______I, am unable or choose not to use the IRS Retrieval tool on the FAFSA. I will submit my 2018 IRS tax return transcript.

________ No…I, the student, did not work and are not required to file a tax return for 2018.

________No…I, the student, did not work but had supporting income {Please complete Table A}

| 2018 Source of Income |Total Amount |

|Child Support Received |$ |

|Social Security or Disability Benefits |$ |

|Welfare benefits (TANF) |$ |

|Untaxed Pensions |$ |

|Workers’ Compensation |$ |

|Monetary support (Money received or paid on your behalf for necessities |$ |

|such as food, bills, housing and living allowance, etc.) | |

Table A {Please Include a Copy of Supporting Documents}

Total $______________

________Yes…I, or my spouse (if married) were employed but did NOT file.

MUST attach a copy of your W-2 Form(s). {Complete Table B}

Table B

| Employer’s Name | 2018 Amount Earned | W-2 Attached? |

| | | |

| | | |

| | | |

|D. Parent’s Income Information |Parent’s SSN |Parent’s DOB |

| |Mother:_______/___/________ |Mother:_____/_____/________ |

| |Father:_______/___/_________ |Father: _____/_____/________ |

ONLY USE BOTH PARENTS INFORMATION IF PARENTS ARE MARRIED

_______ I/we, the student’s Parent(s), did work and have completed my Federal Income Tax for 2018. Attached is a

copy of IRS Tax Return Transcript and W-2 Form(s).

.

_______I/we, the student’s parent(s) did work and have completed my Federal Income Tax for 2018. I/we will be submitting

a copy of the IRS Tax Return Transcript and W-2 Form(s) at a later date.

_______I/we, the student’s parent(s) did work but HAVE NOT completed my/our Federal Income Tax at this time. I/we will be

submitting the IRS Tax Return Transcript once I/we have filed.

_______No…I, the Student’s Parent was not employed and had ZERO INCOME for 2018.

_______No…I, the Student’s Parent DID NOT work but had supporting income for 2018. {Must Complete Table C Below}

Table C {Please Include a Copy of Supporting Documents}

| 2018 Source of Income |Total Amount |

|Child Support Received |$ |

|Social Security or Disability Benefits |$ |

|Welfare benefits (TANF) |$ |

|Untaxed Pensions |$ |

|Workers’ Compensation |$ |

|Monetary support (Money received or paid on your behalf for necessities |$ |

|such as food, bills, housing and living allowance, etc.) | |

Total $______________

_______Yes…I, or my spouse (if married) were employed but did not file.

Attached is a copy of my W-2 Form(s). {Must Complete Table E Below}

Table E

| Employer’s Name | 2018 Amount Earned | W-2 Attached? |

| | | |

| | | |

| | | |

Please provide one of the following documents that include the student’s high school completion status when the student will begin college in 2020-2021:

• A copy of the student’s high school diploma

• A copy of the student’s final official high school transcript that shows the date when

the diploma was awarded.

• A copy of the student’s General Educational Development(GED) certificate, an official

GED transcript that indicates the student passed the exam, or a state-authorized high

school equivalent certificate.

• For students who completed secondary education in a foreign country, a copy of the

“secondary school leaving certificate” or other similar document.

• An academic transcript that indicates the student successfully completed at least a two-

year program that is acceptable for full credit toward a bachelor’s degree.

• For a homeschooled student from a state where state law requires the student to obtain

a secondary school completion credential for homeschool (other than a high school dipl

oma or its recognized equivalent), a copy of the credential.

• For a homeschooled student from a state where state law does not require the student to

obtain a secondary school completion credential for homeschool (other than a high sch

ool diploma or its recognized equivalent), a transcript or the equivalent, signed by the

student’s parent or guardian, that lists the secondary school courses the student com-

pleted and includes a statement that the student successfully completed a secondary

school education in a homeschool setting.

A student who is unable to obtain the documentation listed above must contact the financial aid office.

The student must appear in person at____________________________ to verify his or her identity by

(Name of Postsecondary Educational Institution)

Presenting a valid government-issued photo identification (ID), such as, but not limited to, a driver’s license, other state-issued ID, or passport. The institution will maintain a copy of the student’s photo ID that is annotated by the institution with the date it was received and reviewed and the name of the official at the institution authorized to collect the student’s ID.

In addition, the student must sign, in the presence of the institutional official, the following:

Statement of Educational Purpose

I certify that I ______________________________________am the individual signing this Statement of

(Print Student’s Name)

Educational Purpose and that the Federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending ________________________for 2020-2021.

(Name of Postsecondary Educational Institution)

__________________________________ _________________________________________

Student’s Signature Date

Each person signing below certifies that all of the

information reported is complete and correct. The student

and one parent whose information was reported on the

FAFSA must sign and date.

Please sign before returning {All Dependent Students & Parents}

-----------------------

Rust College Office of Financial Aid

150 Rust Ave

Holly Springs, MS 38635

(662) 252-8000 ext. 4062 Fax: (662) 252-7901

Email:nsmith2@rustcollege.edu

Your 2020-2021 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says that before awarding Federal Student Aid, we may ask you to confirm the information you and your parents reported on your FAFSA. To verify that you provided correct information the financial aid administrator at your school will compare your FAFSA with the information on this worksheet and with any other required documents. If there are differences, your FAFSA information may need to be corrected. You and at least one parent must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to the financial aid administrator at your school. Your school may ask for additional information. If you have questions about verification, contact your financial aid administrator as soon as possible so that your financial aid will not be delayed.

A. Student Information

1. Collect your and your parent(s)’ financial documents (signed Federal Tax forms, W-2 forms, etc.).

2. Complete and sign the verification worksheet. You and at least one parent MUST sign the worksheet.

3. Submit completed verification worksheet, tax forms, and any other documents as requested by the Office of Financial Aid.

4. Contact the Office of Financial Aid if you have questions about completing the verification process.

_________________________________________ ____________________________________

Last Name First Name MI Student ID

_____________________________________________________________ ______________________________________________________

Student Email Address Student Social Security Number

(_____)_______________________________________________________ (_____)________________________________________________

Home Number Parent or Guardian Number

______________________________________________________________ ______________________________________________________

Mailing Address (include Apt. No.) City ST Zip

______________________________________________________________ (____)_________________________________________________

Student Date of Birth Student’s Cell

B. Dependency Status & Household Information

IMPORTANT CHANGES IN VERIFICATION

The next section contains income information for students and Parents. A copy of tax filers 2018 IRS Tax Return and W-2 Form must be attached to this document. To request a copy of your 2018 Federal Tax Return Transcript or 2018 Wage and Tax Transcript, go to and click get transcript of your tax records.

PLEASE DO NOT ORDER AN ACCOUNT TRANSCRIPT

C. Student Income Information

Tax Filing Students

NON TAX FILING STUDENTS with LOW or NO Income (COMPLETE THIS SECTION IF YOU DID NOT FILE TAXES IN 2018).

Tax Filing Parents

NON TAX FILING PARENTS ONLY

High School Completion Status

Identity and Statement of Educational Purpose ( To be Signed at the Institution)

Certifications and Signatures

WARNING: If you purposely give false or misleading information you may be fined, be sentenced to jail, or both.

I/we certify that all information reported is complete and correct. I/we understand that no federal aid can be awarded or disbursed until the verification process is complete.

Student’s Signature___________________________________ Parent’s Signature_________________________________

Date______________ Date_______________

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